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Blood samples were collected and sent for tNGS, metagenomic next-generation sequencing (mNGS), and culture. For patients with indications for surgical interventions, peripancreatic specimens were simultaneously collected for microbial culture during the initial surgical procedure to confirm the presence of IPN. The clinical performance of tNGS, mNGS and culture were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 51 patients, blood tNGS demonstrated a significantly higher positivity rate compared to blood culture (54.9% vs. 17.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), while no statistically significant difference was observed between blood tNGS and blood mNGS (54.9% vs. 51.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.683). tNGS demonstrated superior detection of fungi and Gram-negative bacteria. With peripancreatic culture as the reference standard, tNGS demonstrated superior sensitivity (94.7%), accuracy (81.3%), and concordance rate (78.9%) compared to conventional culture, and exhibited comparable performance to mNGS. tNGS also detected antimicrobial-resistance genes in 7 patients, with findings consistent with available phenotypic susceptibilities. Detection of virulence factors (VF) was associated with higher rates of persistent organ failure (POF) (100.0% vs. 57.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009) and mortality (77.7% vs. 11.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.022). Firth\u2019s bias-reduced logistic regression identified OF\u2009&gt;\u20097 days as an independent predictor of tNGS positivity (OR 4.259,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.040).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Blood tNGS demonstrated diagnostic performance comparable to mNGS in suspected IPN, with potentially greater sensitivity for fungal and Gram-negative pathogens. Its ability to detect VF may offer prognostic insights, but clinical utility requires further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-025-12441-w","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T15:24:30Z","timestamp":1767021870000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical evaluation of probe capture-based targeted next-generation sequencing in suspected infected pancreatic necrosis: a prospective pilot diagnostic study"],"prefix":"10.1186","volume":"26","author":[{"given":"Baiqi","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingcheng","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xintong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiayen","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zefang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caihong","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiarong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengwen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"12441_CR1","doi-asserted-by":"crossref","unstructured":"Liu B, Zhang X, Li J, Sun Z, Lin C, Ning C, Hong X, Zhu S, Shen D, Chen L, et al. 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